The statements in this section merely provide background information related to the present disclosure and may not constitute prior art.
In some instances complications may occur when a fetal presenting part (head or breech) is ‘well applied’ within the mother's pelvis during a cesarean delivery. The incidents are more common when a cesarean delivery is pursued after a natural birthing process is tried unsuccessfully. Since the patient/mother has labored, sometimes the fetal presenting part is well seated in the pelvis and the molding and caput of the head occupy the entirety of the potential space of the pelvic cavity. Particularly, the vagina and cervix are well applied to the head in a very wet environment, and digital or manual extraction from this environment places a large amount of suction on the fetal head, usually causing significant resistance to elevation of the head up through the uterine incision.
Common practice is for a surgical assistant to place his or her hand into the vagina and push up on the fetal presenting part while the surgeon attempts to gain leverage on the presenting part from the surgical field. Often, when the presenting part finally breaks the seal, a large sucking sound is heard as vaginal air and fluids are expelled up into the uterus and surrounding operative field. The force required to accomplish this may be excessive, and may lead to complications such as clavicle fracture of the neonate, tearing and extension of the lower uterine segment incision with significant blood loss, and rarely, skull fracture or inability to deliver the fetus resulting in fetal death.